伴膜增生病变的非典型抗肾小球基底膜肾炎1例报道  

A case report of atypical anti-glomerular basement membrane disease with membrane hyperplasia lesions

作　　者：张昕萍 王自闯[2] 陈小永[1] ZHANG Xinping;WANG Zichuang;CHEN Xiaoyong(Department of Nephrology,Second Clinical Medical College,Henan University of Chinese Medicine,Zhengzhou 450003,China;Department of Pathology,Second Clinical Medical College,Henan University of Chinese Medicine,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学第二临床医学院肾病科,郑州450003 [2]河南中医药大学第二临床医学院病理科,郑州450003

出　　处：《上海交通大学学报（医学版）》2024年第11期1472-1476,共5页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：非典型抗肾小球基底膜(glomerular basement membrane,GBM)肾炎罕见,伴有膜增生病变的更为少见,目前对其治疗方案尚未明确。该文报道1例抗GBM抗体阴性,但肾组织活检提示“肾小球膜增生病变伴IgG线样阳性”的非典型抗GBM肾炎病例。该患者以大量蛋白尿、血尿、水肿、肾功能损伤为主要特征,排除继发因素后经肾组织活检诊断为“非典型抗GBM肾炎”。给予糖皮质激素联合环磷酰胺治疗后,患者出现肺部感染及急性左心衰竭,转院行规律血液透析治疗。后期发展至终末期肾脏病阶段,继续接受规律血液透析治疗。Atypical anti-glomerular basement membrane(GBM)disease is rare,and the atypical anti-GBM disease with membrane hyperplasia lesion is even rarer.The treatment plan for it is not clear.This article reports a case of atypical anti-GBM disease with a negative anti-GBM antibody test,but renal tissue biopsy showed“glomerular membrane hyperplasia lesions with positive IgG linearity”,which provides a reference for clinical diagnosis and treatment.The patient exhibited massive proteinuria,hematuria,edema,and renal impairment.After ruling out secondary factors,the patient was diagnosed with“atypical anti-GBM nephritis”by renal tissue biopsy,and was treated with glucocorticoids combined with cyclophosphamide,after which the patient developed a lung infection and acute left heart failure,and received regular hemodialysis treatment.Then the patient progressed to the stage of end-stage renal disease and continued to receive regular hemodialysis treatment.

关 键 词：非典型抗肾小球基底膜肾炎 膜增生性病变 肾病综合征 

分 类 号：R692.3[医药卫生—泌尿科学]